Alan K Mirly PA

NPI 1891780524 - Physician Assistant - 363A00000X

NPI Details
NPI 1891780524
Gender Male
Enumeration Date 09/19/2005
Last Updated 07/08/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
POCATELLO ID, 83201-2717, US
Phone (208) 232-2146
Fax (208) 232-2770
Business Location
333 N 18TH AVE
POCATELLO ID, 83201-3358, US
Phone (208) 232-2146
Fax (208) 232-2770
Taxonomy Code 363A00000X
License State Idaho
License Number PA-558
Remove 1891780524 NPI Number

According to our database, Alan K Mirly PA NPI is 1891780524, taxonomy code is 363A00000X and license number is PA-558, license state is located at Idaho. Alan K Mirly PA physically located at 755 Hospital Way, Pocatello ID, 83201-2717. NPI Number Alan K Mirly PA has the Individual type.

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1891780524 NPI number is provided on an as is basis without warranty of any kind. 1891780524 is maintained by the National Plan & Provider Enumeration System. The contents of Alan K Mirly PA are for informational purposes only.